Impact of vaginal douching products on vaginal Lactobacillus, Escherichia coli and epithelial immune responses

Hesham, Helai; Mitchell, Alissa J.; Bergerat, Agnès; Hung, Kristin J.; Mitchell, Caroline

doi:10.1038/s41598-021-02426-5

Cited by 13 publications

(5 citation statements)

References 41 publications

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“…Specifically, washing practices are associated with BV acquisition and reduced Lactobacillus abundance ( 67 , 68 ). In one study investigating the effect of vaginal hygiene products on vaginal microbiome found Lactobacillus growth was not inhibited when using vinegar and iodine based products ( 69 ). Instead of directly inhibiting bacterial growth, these products induced epithelial cell death and proinflammatory response in vitro , marked by increased interleukin (IL)-6 and IL-1β.…”

Section: Host Factors Determining Vaginal Microbial Communitymentioning

confidence: 99%

Host and Microbiome Interplay Shapes the Vaginal Microenvironment

Kwon

Lee

2022

Front. Immunol.

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The female reproductive tract harbors a unique microbiome, especially the vagina. The human vaginal microbiome exhibits a low diversity and is dominated by Lactobacillus species, compared to the microbiome of other organs. The host and vaginal microbiome mutually coexist in the vaginal microenvironment. Host cells provide Lactobacillus glycogen as an energy source, and Lactobacillus produce lactic acid, which lowers vaginal pH thereby preventing growth of other bacteria. Bacterial vaginosis can modulate host immune systems, and is frequently associated with various aspects of disease, including sexually transmitted infection, gynecologic cancer, and poor pregnancy outcomes. Because of this, numerous studies focused on the impact of the vaginal microbiome on women`s health and disease. Furthermore, numerous epidemiologic studies also have demonstrated various host factors regulate the vaginal microbiome. The female reproductive tract undergoes constant fluctuations due to hormonal cycle, pregnancy, and other extrinsic factors. Depending on these fluctuations, the vaginal microbiome composition can shift temporally and dynamically. In this review, we highlight the current knowledge of how host factors modulate vaginal microbiome composition and how the vaginal microbiome contributes to maintaining homeostasis or inducing pathogenesis. A better understanding of relationship between host and vaginal microbiome could identify novel targets for diagnosis, prognosis, or treatment of microbiome-related diseases.

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Section: Host Factors Determining Vaginal Microbial Communitymentioning

confidence: 99%

Host and Microbiome Interplay Shapes the Vaginal Microenvironment

Kwon

Lee

2022

Front. Immunol.

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“…Both organs (vulva and vagina) can absorb arsenic, although, anatomically, the vagina absorbs faster. The previous studies demonstrate that arsenic absorbed through the vagina and vulva is distributed more efficiently and effectively than the oral route [12], [27].…”

Section: Discussionmentioning

confidence: 99%

“…These products are applied by sticking them to the vulva or smeared and douching through the vagina. These products' harmful active substances enter and are absorbed by the vagina when the vulva is submerged for a long time or through the vaginal douching process [12].…”

Section: Introductionmentioning

confidence: 99%

The Effect and Activity of Free Radical Enzymes Due to Arsenic Exposure Through the Vulva and Vagina

Irnawati

Idroes

Akmal

et al. 2022

Open Access Maced J Med Sci

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BACKGROUND OF THE STUDY: Geogenic arsenic is ubiquitous, found in water and soil that is used daily, can be exposed to the female body through the genital organs. The vulva and vagina are open channels that allow toxic agents to enter the internal genitalia and distributed throughout the body. AIM OF THE STUDY: This study investigated the effects of vaginal arsenic exposure via vulvar immersion and vaginal douching in Rattus norvegicus on the damage of uterus and ovaries through oxidative mechanisms (MDA, SOD, and H₂O₂). METHODOLOGY: The experimental animals were divided into three treatment groups, i.e., K0 (control group), K1 (group treated with vulvar immersion in 0.8 mg/L arsenic solution), and K2 (group treated with vaginal douching using 0.5-mL of 0.8 mg/L arsenic solution). For each group, the treatment was repeated six times and carried out for fourteen days. Before the study, a seven-day acclimatization period was conducted for adaptation purposes. The experimental animals were euthanized using ketamine xylazine. The uterus and ovaries were collected for MDA, SOD, and H₂O analysis, as well as histopathology examination. RESULTS: The vaginal douching group had the highest MDA level both on the uterus (210.66±4.92μM) and the ovaries (214.67±2.50 μM). The immersion group also experienced an increase in MDA in the uterus (198.66±3.33μM) and ovaries (206.33± .21μM). However, a higher level of MDA was found in the ovaries. The highest H₂O₂ level was also found in the uterine and ovarian organs in the douching group. In contrast, the lowest SOD levels of uterine and ovarian were identified in the vaginal douching group. Arsenic exposure through vaginal immersion and douching affected the uterine MDA, SOD, and H₂O levels (Ρ<0.05). Arsenic exposure through vaginal douching also affected the ovarian MDA, SOD, and H₂O levels (Ρ<0.05). There was a significant difference in the mean of inflammatory cells (infiltrated neutrophils, macrophages, and lymphocytes) in the uterus and ovaries in the control, immersion, and vaginal douching groups (Ρ<0.05). CONCLUSION: Exposure to 0.8 mg/L arsenic solution through vulvar immersion and vaginal douching can cause oxidative stress and trigger inflammation of the uterine and ovarian tissue.

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“…Vaginal douching is a method of flushing a product through the vagina, often as an attempt to address vaginal discomfort or discharge. An in vitro 2021 study found that the contents of common commercial douching products (vinegar, iodine and baking soda) all may be associated with epithelial inflammation and disruption of the anti-inflammatory effects of lactobacilli ( 140 ). It is hypothesized that increased inflammation may inhibit recolonization of beneficial lactobacilli.…”

Section: Complementary and Alternative Optionsmentioning

confidence: 99%

Bacterial vaginosis: a review of approaches to treatment and prevention

Abbe

Mitchell

2023

Front. Reprod. Health

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Bacterial vaginosis (BV) is a common cause of vaginitis worldwide and is associated with serious reproductive health outcomes, including increased risk of preterm birth, sexually transmitted infections, and pelvic inflammatory disease. The current and only FDA-approved treatment regimens for BV are antibiotics, such as metronidazole and clindamycin. Antibiotics provide a short-term cure for bacterial vaginosis; however, fail to provide a consistent long-term cure for many women. Fifty to eighty percent of women experience a BV recurrence within a year of completing antibiotic treatment. This may be because after antibiotic treatment, beneficial strains of Lactobacillus, such as L. crispatus, do not recolonize the vagina. In the absence of an effective long-term cure, patients, providers, and researchers are exploring different approaches to treatment and prevention, resulting in a rapid evolution of perspectives on BV pathogenesis and approaches to management. Current areas of investigation for BV management include probiotics, vaginal microbiome transplantation, pH modulation, and biofilm disruption. Behavioral modifications that may help include smoking cessation, condom use and hormonal contraception. Additional strategies considered by many people include dietary modification, non-medical vaginally applied products, choice of lubricant, and treatments from medical practices outside of allopathic medicine. This review aims to provide a comprehensive and up to date outline of the landscape of ongoing and potential treatment and prevention strategies for BV.

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Impact of vaginal douching products on vaginal Lactobacillus, Escherichia coli and epithelial immune responses

Cited by 13 publications

References 41 publications

Host and Microbiome Interplay Shapes the Vaginal Microenvironment

Host and Microbiome Interplay Shapes the Vaginal Microenvironment

The Effect and Activity of Free Radical Enzymes Due to Arsenic Exposure Through the Vulva and Vagina

Bacterial vaginosis: a review of approaches to treatment and prevention

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